Thomas R. Russell, MD, FACS, Executive Director of the American College Surgeons (ACS) from January 2000 to January 2010, died August 4 at his ranch in Philo, CA, at age 73 after a four-year battle with cancer. ACS Fellows, the surgical community, College staff, and, perhaps most importantly, the thousands of patients to whom he provided care during his years in practice as a general and colon and rectal surgeon, fondly remember him as a kind, compassionate, and committed leader.
Childhood and education
Dr. Russell was the son of Floyd and Marianna Russell. A native of San Francisco, he attended Town School for Boys and then The Thacher School—a highly selective high school in Ojai, CA. One of the unique characteristics of The Thacher School is that it augments a challenging academic program with lessons learned from the care of horses and camping. Like his classmates, Tom would start every day by caring for his horse before breakfast and going to class. This experience had a profound effect on him, and he remained dedicated to Thacher and its principles—honor, fairness, kindness, and truth—throughout his life.
At age 15 he spent his summer as a wrangler at the Tumbling McD Dude Ranch in Philo. He returned the next year as chief wrangler, a position he filled every summer until his second year of medical school. He claimed that he developed his remarkable talent for remembering people’s names and life stories while taking care of 40 dudes a week at the ranch.
As a youth, Dr. Russell was also an excellent tennis player. In fact, at one time, the local pro had his mother convinced that with a few more lessons, he could go to Wimbledon. He kept up his game throughout his life, with surgical chiefs and admirals seeking him out as a partner.
Ultimately, however, Dr. Russell chose more scholarly pursuits. He earned a bachelor of arts degree in zoology from the University of California, Berkeley, in 1962 and his medical degree from Creighton University Medical School, Omaha, NE, in 1966. It was during medical school that Tom adopted the motto he would follow well into his years as ACS Executive Director: “Take the stairs, be nice to the janitor, and the patient comes first.”
Military service, training, and practice
He did a rotating internship at San Francisco General Hospital from 1966 to 1967 and began his general surgery residency at the University of California, San Francisco (UCSF), in 1967. His residency training was interrupted by service in the Vietnam War from 1968 to 1970, during which he was a Lieutenant Commander and U.S. Navy flight surgeon aboard the U.S.S. Ticonderoga and the U.S.S. Forrestal.
Dr. Russell resumed his surgical training at UCSF in 1971 and completed it in 1975. During those same years, he undertook a research project on gastrointestinal hormones physiology at the Veterans Hospital-Fort Miley in San Francisco and a fellowship under world-renowned pancreatic surgeon Maurice Mercadier, MD, at the L’Hopital de la Pitie, part of the Hopitaux de Paris, France.
In 1975, Dr. Russell joined the practice of Donald M. Gallagher, MD, FACS, and Peter Volpe, MD, FACS, initially taking a preceptorship in colon and rectal surgery and then practicing in this specialty in San Francisco for nearly 25 years. By 1980, Presbyterian Hospital—formerly the Sanford Hospital and now the California Pacific Medical Center—recognized him for his patient care philosophy, his teaching of residents, and his ability to lead, naming him chair of its department of surgery, a position he held until he moved to Chicago, IL, in 2000. His wife of 35 years, Nona Chiampi Russell, MD, a pathologist, also practiced at this institution.
Tom was affiliated with several other hospitals in the San Francisco area and trained, mentored, and inspired countless residents and medical students as a clinical professor of surgery at UCSF. Students and residents always commented on Tom’s unique ability to remember their names and the names of their loved ones, as well as his willingness to always make time to listen to them—to understand their aspirations and to help them move forward in their careers.
Right man for the job
Tom became a Fellow of the ACS in 1979. He was elected to the Board of Governors in 1990 and served in that role until 1993, when he was elected to the Board of Regents. He served two consecutive three-year terms as a Regent, during which time he was a member (1994–1995) and Chair (1998–1999) of the Nominating Committee, a member of the Member Services Liaison Committee (1993–1999), and a member of the Advisory Council for Colon and Rectal Surgery (1993–2000).
The two years leading up to Dr. Russell assuming the role of ACS Executive Director were difficult for our College, and staff morale was low. Furthermore, the Institute of Medicine was poised to release its groundbreaking report To Err Is Human: Building a Safer Health System, which brought to the nation’s attention the number of complications and deaths resulting from medical and surgical error.
Given these internal and external stressors, the College was in need of thoughtful and compassionate leadership. Tom was the right person for the job. Among the Regents and in professional circles, he had a reputation as a bright, kind, high-energy individual who was willing to weigh all sides of an issue. As C. James Carrico, MD, FACS, then Chair of the Board of Regents said, “One of Tom’s greatest strengths is his level-headed approach to problem solving. He listens to all parties objectively and is able to come to a reasonable solution and to reach consensus with all parties concerned.”*
Dr. Russell would go on to lead the College through 10 years of considerable growth and necessary change. Soon after assuming the position of Executive Director, he initiated a strategic planning process to do away with outmoded policies and program structures. He reorganized the College into four divisions: Education, Research and Optimal Patient Care, Advocacy and Health Policy, and Member Services. The College also developed a mission statement to guide the work of staff and volunteers alike: “The American College of Surgeons is dedicated to improving the care of the surgical patient and to safeguarding standards of care in an optimal and ethical practice environment.”
Emphasis on quality and education
Perhaps one of Dr. Russell’s most significant accomplishments as ACS Executive Director was bringing the Veterans Affairs (VA) National Surgical Quality Improvement Program, which had been credited with substantial improvement in the quality of care provided to veterans, into the private sector under the College’s aegis as ACS NSQIP®. He worked with ACS Past-President R. Scott Jones, MD, FACS, and Shukri Khuri, MD, FACS, the surgeon who had launched the program at the VA, to make this happen. With the VA’s blessing and funding from the Agency for Healthcare Research and Quality (AHRQ) and the ACS Finance Committee, ACS NSQIP launched in 2004.† The more than 550 hospitals that have since participated in ACS NSQIP, now under the direction of Clifford Y. Ko, MD, MS, MSHS, FACS, have used the program’s risk-adjusted, evidence-based outcomes data to significantly reduce complications, limit error, and save countless lives and millions of dollars. Dr. Russell was the driving force behind the ACS Clinical Scholars in Residence Program, through which surgical residents are able to contribute on-site to the College’s quality improvement programs.
In addition, Dr. Russell guided the expansion of the College’s educational programming. In 2001, he tapped Ajit K. Sachdeva, MD, FACS, to serve as Director of the ACS Division of Education. “Sach” quickly began redesigning the Clinical Congress and other ACS educational programs with the goal of assisting surgeons in their efforts to meet new and evolving maintenance of certification requirements. Moreover, the College began offering more hands-on Postgraduate Courses and simulated training programs at ACS Accredited Education Institutes to help surgeons become more adept in the use of advanced technology.
Under Tom’s direction, the College established the ACS Foundation in 2005 to better support its scholarship programs. This move resulted in significant expansion of the educational opportunities that the College provides to residents and surgeon researchers. He was installed as Chair of the Foundation’s Board of Directors in October 2009—a position he held until February 2013.
Advocacy and visibility
The early 2000s were politically charged years for health care, culminating in the passage of the Affordable Care Act in March 2010. Of particular concern to surgeons were the ongoing threats to reimbursement stemming from the use of the sustainable growth rate formula to calculate Medicare payment. This payment cut and other legislative measures had the potential to seriously jeopardize access of patients to surgery. Dr. Russell encouraged the College to take a proactive stance.
To improve the College’s visibility and influence in Washington, the Board of Governors’ Committee on Socioeconomic Issues, chaired by Andrew L. Warshaw, MD, FACS, FRCSEd(Hon), suggested that the College establish a political action committee (PAC). Because of its tax-exempt status as an educational group, the College itself could not create its own PAC. Dr. Russell and the Regents moved forward with the development of the American College of Surgeons Professional Association (ACSPA), which would have the ability to develop a PAC. The ACSPA-SurgeonsPAC was established in 2002 and contributes to the election campaigns of candidates who are supportive of the surgical community’s political agenda.
In addition, Dr. Russell and Cynthia A. Brown, then Director of the ACS Division of Advocacy and Health Policy, led an effort to expand the Washington Office’s lobbying and health policy staff. To accommodate this growth, the Washington Office needed to relocate to a larger facility—preferably one closer to Capitol Hill than its Georgetown location. The Regents’ approved a plan developed by ACS Chief Financial Officer Gay L. Vincent to construct a 10-story building at 20 F Street, NW, which is in walking distance to Capitol Hill.† The building officially opened its doors in 2010.
To further improve the College’s visibility, the ACS established a Public Profile and Communications Committee, chaired by ACS Regent Jack McAninch, MD, FACS, and hired the public relations firm Weber Shandwick to broaden the College’s reach to media outlets. In addition, a fifth division of the College, Integrated Communications, was created under Linn Meyer to further raise the College’s public profile.
Inclusiveness
Perhaps Tom’s greatest legacy as Executive Director, however, will be his ability to connect with all surgeons and ACS staff. Dr. Russell traveled extensively as Executive Director, participating in entire chapter meetings so as to gain insights into the experiences and views of the broad ACS membership. Furthermore, he opened up ACS membership to anesthesiologists, nurses, and other members of the operating room team, so that they could all share common educational experiences at the Clinical Congress and other College-sponsored programs.
He reached out to the leadership of the American Society of General Surgeons (ASGS), which had a somewhat antagonistic relationship with the College, and under his leadership, ASGS was given specialty society representation on the ACS Board of Governors.‡ To make the College’s resources more widely available to some of the smaller surgical specialty societies, the ACS also began providing association management services to these groups.
Other initiatives that Dr. Russell led include the following: the establishment of Operation Giving Back at the suggestion of Dr. Warshaw and the Governors Committee on Socioeconomic Issues; improvements in ACS Trauma Programs through the recruitment of our current Executive Director, David B. Hoyt, MD, FACS, as Medical Director; the refurbishment of the Murphy Memorial Auditorium Building in Chicago, IL; and restoration of the College’s Archival materials.
Tom was a highly respected and well-liked leader, not only among the ACS members, but among the organization’s staff as well. Many staff members have fond memories of him making his morning “rounds,” stopping by their desks to see how they were doing. Tom had an open-door policy and was always willing to listen to employees’ concerns about the workplace or to offer counsel to individuals with ailing family members. As a testament to his positive effect on staff morale, employee turnover dropped to 5 percent from 27 percent.‡
His spirit lives on
He was a devoted and loving family man and is survived by his wife, Nona; his daughters, Katie Russell, who is currently a chief surgery resident at the University of Utah, Salt Lake City, and soon to be a pediatric surgery fellow at Children’s Hospital of Philadelphia, PA, and Jackie Russell, a student in veterinary medicine at the University of California, Davis; his sister, Susie Tompkins Buell; two nieces, Quincey and Summer; and numerous grand-nephews and nieces. Always a cowboy at heart, Tom returned with his family to their ranch in Philo as often as their busy schedules would allow.
Dr. Russell remained fiercely loyal to the armed services throughout his life. Indeed, despite the fact that he could have undergone treatment wherever he wanted, he went to the Ft. Miley VA Hospital for much of his medical care.
He was a man of enormous integrity and generosity, and with his gentle humor and enduring optimism, he had a gift for bringing out the best in people. His imprint will permanently remain on the College and the many lives he touched.
The College will honor Dr. Russell with the presentation of its Lifetime Achievement Award at the Clinical Congress this month in San Francisco. Any donations in Tom’s memory should be made to The Thacher School in Ojai; the San Francisco Achievers, a public high school mentoring and scholarship program; or the Thomas R. Russell, MD, FACS, Scholarship Fund at the ACS.
Editor’s note: A “Celebration of Life” service in memory of Dr. Russell will take place at the 2014 Clinical Congress, Wednesday, October 29, beginning at 6:00 pm in Room 130–131, Moscone Center North, San Francisco, CA. All Clinical Congress participants are invited to attend.
*College news: Thomas R. Russell, MD, FACS, named Executive Director. Bull Am Coll Surg. 1999;84(12):48-49.
†Nahrwold DL, Kernahan PJ. Emphasis on the Fellowship. In: A Century of Surgeons and Surgery: The American College of Surgeons, 1913–2012. Chicago, IL: The American College of Surgeons. 2012:335-349.
‡Nahrwold DL, Kernahan PJ. Health Policy, a New Building, and a New Director. A Century of Surgeons and Surgery: The American College of Surgeons, 1913–2012. Chicago, IL: The American College of Surgeons. 2012:361-369.
